Quote :

"It is widely assumed that health care, like most aspects of American life, shamefully shortchanges the poor. This is less true than it seems. Economist Gary Burtless of the Brookings Institution recently discovered these astonishing data: On average, annual health spending per person -- from all private and government sources -- is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest (see table). Probably in no other area, notes Burtless, is spending so equal -- not in housing, clothes, transportation or anything. Why? One reason: Government already insures more than a quarter of the population, including many poor. Medicare covers the elderly; Medicaid, many of the poor and their children; SCHIP (State Children's Health Insurance Program), more children. Another reason is the skewing of health spending toward the very sick; 10 percent of patients account for two-thirds of spending. Regardless of income, people get thrust onto a conveyor belt of costly care: long hospital stays, many tests, therapies and surgeries. "

http://www.washingtonpost.com/wp-dyn/content/article/2008/09/09/AR2008090902520.html

9/10/2008 6:40:14 PM

don't know if i'm missing something here, but i'm pretty sure the argument would be that a poor person is much more affected by a $5,000 a year than an affluent person.

9/10/2008 6:53:17 PM

Quote :

"don't know if i'm missing something here, but i'm pretty sure the argument would be that a poor person is much more affected by a $5,000 a year than an affluent person."

You are missing something, this is government and private insurance spending per person

9/10/2008 7:26:25 PM

I thought people always complained we spent too much money on poor people.

9/10/2008 7:44:06 PM

^That complaint is invalidated by this study? The rich are probably paying for their own health care while the poor are relying on someone else to pay for it. The people that complained about spending too much on the poor will go right on complaining because they are still paying for their health care.

I thought the point of the quote above, at least from the opening paragraph, was that the notion that poor people received inferior health care because they were poor might not be based in reality.

9/10/2008 8:06:40 PM

Well this study says nothing about care or type of care, just total spending. You can still ask:

1) Why are these people going in? Id imagine someone with lots of money would be more inclined to go in for a sinus infection than someone who is poor. Someone who is poor might not have the best diet/exercise opportunity, so maybe theyre going in for obesity, disease, etc while the rich are going in for things less serious.
2) The quality of care is not addressed at all. The cost certainly reflects some measure of quality but doesnt tell the whole story
3) Im assuming the study is for all age groups? Who knows
4) Has this changed over time
etc etc etc

Not trying to question anything, just trying to show that only so much can be taken from this

9/10/2008 9:13:57 PM

fat poor people.

9/10/2008 9:41:45 PM

It may have helped to post the article in its entirety to get a better sense of context.

Quote :

"Unless you've been living in the Himalayas, you know that huge numbers of Americans -- 46 million last year -- lack health insurance. By impressive majorities, Americans regard this as a moral stain. At the Democratic National Convention, Sen. Ted Kennedy echoed the view of many that health care is a "right" that demands universal insurance. This completely understandable view is, I think, utterly wrong. Take note, Barack Obama and John McCain. The central health-care problem is not improving coverage. It's controlling costs. In 1960, health care accounted for $1 of every $20 spent in the U.S. economy; now that's $1 of every $6, and the Congressional Budget Office projects that it could be $1 of every $4 by 2025. Ponder that: a quarter of the U.S. economy devoted to health care. Would we be better off? Probably not. Countless studies have shown that many tests, surgeries and medical devices are either ineffective or unneeded. Greater health-care spending forfeits any superior moral claim on our wealth by slowly crowding out other national needs. For government, higher health costs threaten other programs -- schools, roads, defense, scientific research -- and put upward pressure on taxes. For workers, increasingly expensive insurance depresses take-home pay as employers funnel more compensation dollars into coverage. There's also a massive and undesirable income transfer from the young to the old, accomplished through taxes and the cross-subsidies of private insurance, because the old are the biggest users of medical care. It is widely assumed that health care, like most aspects of American life, shamefully shortchanges the poor. This is less true than it seems. Economist Gary Burtless of the Brookings Institution recently discovered these astonishing data: On average, annual health spending per person -- from all private and government sources -- is equal for the poorest and the richest Americans. In 2003, it was $4,477 for the poorest fifth and $4,451 for the richest (see table). Probably in no other area, notes Burtless, is spending so equal -- not in housing, clothes, transportation or anything. Why? One reason: Government already insures more than a quarter of the population, including many poor. Medicare covers the elderly; Medicaid, many of the poor and their children; SCHIP (State Children's Health Insurance Program), more children. Another reason is the skewing of health spending toward the very sick; 10 percent of patients account for two-thirds of spending. Regardless of income, people get thrust onto a conveyor belt of costly care: long hospital stays, many tests, therapies and surgeries. That includes the uninsured. In 2008, their care will cost about $86 billion, estimates a study for the Kaiser Family Foundation. The uninsured pay about $30 billion themselves; the rest is uncompensated. Of course, no sane person wants to be without health insurance, and the uninsured receive less care and, by some studies, suffer abnormally high death rates. But other studies suggest only minor disadvantages for the uninsured. One study compared the insured and uninsured after the onset of a chronic illness -- say, heart disease or diabetes. Outcomes differed little. After about six months, 20.4 percent of the insured and 20.9 percent of the uninsured judged themselves "better"; 32.2 percent of the insured and 35.2 percent of the uninsured rated themselves "worse." The rest saw no change. The trouble with casting medical care as a "right" is that this ignores how open-ended the "right" should be and how fulfilling it might compromise other "rights" and needs. What makes people healthy or unhealthy are personal habits, good or bad (diet, exercise, alcohol and drug use); genetic makeup, lucky or unlucky; and age. Health care, no matter how lavishly provided, can only partly compensate for these individual differences. There is a basic dilemma that most Americans refuse to acknowledge. What we all want for ourselves and our families -- access to unlimited care paid for by someone else -- may be ruinous for us as a society. The crying need now is not to insure all the uninsured. This would be expensive (an additional $123 billion a year, estimates the Kaiser study) and would provide modest health gains at best. Two- fifths of the uninsured are young (19 to 34) and relatively healthy. The McCain and Obama health-care proposals, either impractical or undesirable, largely ignore the existing challenge of Medicare. By some studies, 30 percent of its spending may go to unneeded services. Medicare is so large that by altering how it operates, government can reshape the entire health-care system. This would require changes to encourage more electronic record-keeping, better case management, fewer dubious tests and procedures, and a fairer sharing of costs between the young and the old. The work would be unglamorous and probably unpopular. But if the next president can't do it, his presidency will fail in one fateful way. "

[Edited on September 10, 2008 at 10:08 PM. Reason : .]

9/10/2008 10:08:02 PM

http://www.investorguide.com/taxtrackr/

[Edited on September 15, 2008 at 8:56 AM. Reason : this is interesting]

9/15/2008 8:51:03 AM

Colemania, but the point is that this is a major shift in the current policy debate.

For example, in presidential politics, the argument the Obama campaign seems to be giving is that if you are poor, you cannot afford private insurance, therefore you cannot afford to purchase health care services once you get sick. To fix this problem he proposes forcing private insurance companies to sell health insurance to anyone that wants it.

In reality, this study indicates that even though many "poor" people don't have private insurance, existing government programs actually already provides them with assistance so that they can afford the same ammount health care services as "rich" people purchase (measured in dollars). IOW: the problem the Obama health care plan is set out to fix may not exist (and if you believe critics of the plan, like Paul Krugman, it may actually create new problems).

Now, if you want to ask wheter "poor" people still receive a lower quality of care (maybe hospitals in poor areas are worse? doctors less competent? don't know what argument you want to make), that is certainly a legit question. But that is a fundamental shift in health care policy discourse. Up until now, everyone has been focused on the ability to afford health care. But it looks like those worries may be unfounded.

Of course, this is just one study.

[Edited on September 15, 2008 at 12:11 PM. Reason : ``]

9/15/2008 12:10:52 PM

Anecdotal evidence makes it clear many poor and middle class folks lack access to health care. It's not an invented problem.

9/15/2008 12:21:36 PM

^ That being the case, this study then indicates that the government sucks at providing health care, as despite the fact that they spend as much as private companies, the don't provide equal care. Yet people still believe that universal government coverage is the way to go.

9/15/2008 1:42:19 PM

b/c the govt does a bang-up job on controlling our education system. why don't we give them the healthcare system

next up: let's give them the power companies, heck why not? b/c hey, free energy!

9/15/2008 1:44:10 PM

^^ Perhaps. On the other hand, the example from other countries counters that. They spend less on health care but have superior overall health results. It could be that the specific arrangement in this country, to use your term, sucks. That doesn't mean any possible government program would be similarly full of fail.

9/15/2008 1:52:04 PM

Most other countries are also have significantly smaller populations and less area in which the population is contained. I fairly certain a socialized healthcare system could work on a state level, even though I would despise it, but when you get to the federal level, you start running into problems just from the sheer size and inefficiencies.

9/15/2008 2:17:35 PM

Quote :

"They spend less on health care but have superior overall health results."

The "health results" are often based on health variables that have little do to with our health system and more to do with our lifestyles.

9/15/2008 3:09:08 PM

Quote :

"b/c the govt does a bang-up job on controlling our education system. why don't we give them the healthcare system next up: let's give them the power companies, heck why not? b/c hey, free energy!"

The shortcomings of our education system usually stem from a marked attempt on the part of conservatives to block or ruin it

*ruins public education*
"Hey look, the government can't do ANYTHING right!" *slide-whistle*

[Edited on September 15, 2008 at 5:08 PM. Reason : .]

9/15/2008 4:59:18 PM

^ or it could be due to the fact that we effectively have a government-run monopoly in K-12 education. Without providing parents a choice in schools, schools/bureaucrats are not incentivized to meet the needs of their customers.

message_topic.aspx?topic=536651

9/15/2008 5:46:25 PM

it's not that the government can't do anything these days.. it's more.....

BUT THE GOVERNMENT CAN DO ANYTHING BETTER!!!11


btw, take note all republicans and democrats.

You have more sway in this country with how you spend your dollars than with how you cast your vote this November. Keep that in mind.


Obama nor Hillary will be able to get free healthcare for this country. Perhaps a form of it, but it ain't gonna happen.

B/c hey, free everything!!!11

[Edited on September 15, 2008 at 6:22 PM. Reason : s]

9/15/2008 6:22:16 PM

Quote :

"The shortcomings of our education system usually stem from a marked attempt on the part of conservatives to block or ruin it"

Proof?

9/15/2008 7:41:30 PM

Quote :

"Anecdotal evidence makes it clear many poor and middle class folks lack access to health care. It's not an invented problem."

GoldenViper

But define many. How many people are not currently privately insured and are not covered by medicare and medicaid? How many of those actually qualify for those existing programs and simply don't sign up? And of those still remaining, how many are younger than 30 (tending to be just entering the job market and also being relatively healthy and thus not necc. needing/wanting to purchase health insurance)?

One issue I actually have changed my mind on the past year is that I do not believe the problem facing our health care system is one of access. If you are just down-and-out broke, you will get access to health care through medicaid and further assistance from other programs. The problem I would like to see most addressed is that of rising costs. And is this is probably the result of our flawed tort system, excessive state restrictions on what insurance packages must cover, among other things.

Though, I admit I am not 100% convinced either way yet.

9/15/2008 10:22:08 PM

Quote :

"How many people are not currently privately insured and are not covered by medicare and medicaid?"

Millions, supposedly. Somewhere between twenty and forty million.

Quote :

"How many of those actually qualify for those existing programs and simply don't sign up?"

Probably quite a few, as Medicaid is damn confusing. That's one advantage (in theory) of the single-payer system. You don't have to worry about as much bullshit. Are you covered? By which company? Oh, I'm covered by the state, not private insurance. Oh, I'm covered for this but not for that. What a pain in the ass.

9/15/2008 10:34:54 PM

Flawed logic. I don't know what you are trying to prove but lets keep in mind that rich people tend to stay healthy relative to poor people because they have access to other health related things that surely aren't counted in this "spending". Also poor people live in unhealthy environments (working, living conditions) so the risks are just much greater.

A better study would be to look at spending data on poor people vs rich people with the same health problems. IE rich diabetic vs poor diabetic.

9/15/2008 11:02:27 PM

Quote :

"Millions, supposedly. Somewhere between twenty and forty million."

gonna need a source for that. And heaven help you if you even begin to include illegal immigrants in that figure.

Quote :

"Probably quite a few, as Medicaid is damn confusing."

And yet, there is still a solution for them that already exists. Maybe instead of creating a monolithic behemoth of a gov't system, we should simply ask that people take advantage of the systems we already have in place. Then we can figure out how many are truly "not insured."

Quote :

"That's one advantage (in theory) of the single-payer system. You don't have to worry about as much bullshit. Are you covered? By which company? Oh, I'm covered by the state, not private insurance. Oh, I'm covered for this but not for that. What a pain in the ass."

And this goes back to curtailing the rising costs due to factors that have been mentioned ad nauseum. If people didn't need insurance to afford the equivalent of a car oil change, then maybe they would go ahead and pay for that stuff out of pocket, thus short-circuiting the need for a massive federal health care program.

9/15/2008 11:37:59 PM

Quote :

"Annual Census Bureau estimates released in August show 47 million people, or 15.8 percent of the U.S. population, were without health insurance during 2006 — a 4.9 percent increase."

http://www.google.com/search?hl=en&q=uninsured+americans&btnG=Search

[Edited on September 16, 2008 at 12:02 AM. Reason : fourth search result... damn it]

9/15/2008 11:53:59 PM

that is not a valid source. It does NOT factor in those who are eligible for medicaid and medicare. as well, it factors in illegal immigrants.

oh, and way to list an article that requires a username and password, silly.

9/15/2008 11:55:36 PM

Quote :

"It does NOT factor in those who are eligible for medicaid and medicare."

That would reduce the figure by about 25%.

http://www.bcbs.com/blueresources/mcrg/chapter2/ch2_slide_27.html

Quote :

"oh, and way to list an article that requires a username and password, silly."

That's a lie.

[Edited on September 16, 2008 at 12:01 AM. Reason : don't lie]

9/16/2008 12:00:39 AM

GV, that is the same number that gets floated around frequently, but as boro pointed out, that doesn't consider who is actually eligible for existing programs.

It also doesn't even attempt to measure how many of those people don't have insurance simply because they can't afford it versus people that simply don't want insurance (i went 2 months without insurance when I was between jobs a few years ago, would I have been counted?).

PS* Medscape asks me username and password too.

[Edited on September 16, 2008 at 12:02 AM. Reason : ``]

9/16/2008 12:01:24 AM

i like how you edited out the original link that DOES require a username and password. come on, man.

9/16/2008 12:02:01 AM

It only requires such when linked directly. Click on it from Google and it works fine. That's the cause of the problem.

9/16/2008 12:03:49 AM

and yet, you provided us the direct link...

9/16/2008 12:05:28 AM

I didn't know the damn thing would be funky. I got there from Google and merely copied the URL.

Anyways, 75% of 47 million would be about 35 million. More than 10% of the population.

[Edited on September 16, 2008 at 12:09 AM. Reason : ten percent]

9/16/2008 12:07:17 AM

well, how about you not call somebody a liar when you can't fucking reference something correctly, ok?

9/16/2008 12:08:55 AM

I won't take responsibility for funky sites.

(The liar bit was meant to be tongue-in-cheek.)

9/16/2008 12:11:22 AM

man, TSB's sarcasm detectors have been totally off today

but, typical liberal: won't take responsibility for his mistakes

9/16/2008 12:13:56 AM

I'm a radical, not a liberal. Other than that, you're correct. I won't take responsibility for the insanity of a site hiding the content if you click on the URL and press enter! If I've encountered that before, it was a long time ago.

9/16/2008 12:19:00 AM

in a land far, far away

9/16/2008 12:19:46 AM

GV,

You forgot to mention that your BCBS link also mentions that another 20% of uninsured individuals can afford insurance that are not elidgble for public programs. That means only 56% of that 47 million actually is not elidgble for government programs like medicaid and medicare and cannot afford private alternatives.

That is 26 million people or about 9% of the 300 million people that live in the United States (just using the sources you provided), which is actually about what the national poverty rate is. That is a very very sad fact, but not a national emergency. Access simply is not the problem.

[Edited on September 16, 2008 at 12:26 AM. Reason : ``]

9/16/2008 12:25:07 AM

and, guess how many of those 26million are illegal immigrants, socks?

9/16/2008 12:27:19 AM

Health care is an issue for more than just the uninsured. (Or, in this case, an issue for more than just the uninsured who really can't afford insurance and who don't quality for Medicaid.) Even if you have health insurance, a major disaster might still leave you in the poorhouse. Insurance companies pull all sorts of shady shit to deny claims.

9/16/2008 12:35:55 AM

ooooooooh, switching gears, are we...

9/16/2008 12:39:44 AM

What choice do I have? I consider the fact that millions lack health insurance a major problem. Y'all don't. I'm not sure where to go with that. We've established the facts. We react to them differently. Apparently, the uninsured masses aren't enough to catch your attention. I figure the real struggles the insured face might.

9/16/2008 12:49:55 AM

well, you can't even show that there are truly uninsured masses. The best you can come up with are figures that show that the number of "uninsured" is massively inflated.

9/16/2008 12:55:12 AM

Again, I don't where to go from here. I consider millions to be masses. If you don't, you don't. I also fail to see why you discount the many millions who lack health insurance for other reasons. What good does being eligible for Medicaid do if you aren't actually enrolled? What good does having the ability to afford health insurance do once you're already facing giant medical bills?

9/16/2008 1:02:26 AM

Quote :

"What good does having the ability to afford health insurance do once you're already facing giant medical bills?"

A large portion of the 9% are also transitory, so the probability of any one of the 9% uninsured facing large medical bills is extremely small (especially considering a large number are below 30 yrs old).

The fundamental problem is not the uninsured, but the rising cost of health care. This is primarily due to excessive regulations that prevent competition in the health care industry. Due to overly-strict licensure laws, we have a shortage of medical practitioners. Due to excessive state mandates, we do not have an affordable, bare-bones insurance plan to simply cover low-probability events (Each state requires a laundry-list of mandated benefits, many the result of special-interest lobbying. This leads the uninsured to have few, expensive options. These mandates would be similar to limiting our car choices to only fully-loaded Lexus'.) A simple solution to our ER problem would be to have more specialized community care centers. This does not happen because we have excessive state mandates that force all such centers to include a plethora of services, preventing many volunteer doctors/nurses/ect from being able to quickly, easily and affordably open up community care centers. What began as well-intentioned regulation resulted in people using the ER.

There is also the problem of over-consumption of health care services. When a third party is paying most of the bill, there is no incentive to be cognizant of costs. Neither the consumer nor the supplier are incentivized to be more efficient. The AARP estimated about 20% (I cannot recall the exact percentage) of the health care services we consume is unnecessary and has no benefit. Has anyone ever asked their doctor the costs and benefits of any given series of tests or procedures?

Until we increase competition and incentivize consumers and producers to be more efficient and cost-conscience, prices will continue to spiral out of control and insurance premiums will continue to rise.


[Edited on September 16, 2008 at 7:15 AM. Reason : ,]

9/16/2008 6:58:33 AM

GoldenViper,

But you are not considering the fact that these are not the same people from year to year. As I just pointed out, I went without health insurance back in 2005 for 2 or 3 months after I graduated. How many of those millions of people are actually young men and women just entering the work force?

Look, I seriously doubt 9% of the population spend their entire lives without seeing a doctor. And that number is still probably inflated because of cyclical factors not related to structural problems in the health care market (when the economy turns sour, it isn't a surprise that people are losing their jobs and their health insurance, it's actually one way we measure whether the economy is turning sour to begin with). That isn't even to mention the problems AAb brought up.

None of this reveals a major problem with health care access in this country. Now, if you want to talk about people that already have insurance, they would be much more concerned about rising health care costs than anything else. Which is exactly what I'm saying.

9/16/2008 7:03:55 AM

Quote :

"Due to overly-strict licensure laws, we have a shortage of medical practitioners."

Opening up these jobs to foreign professionals would go a long way towards solving this problem and thus dramatically decrease costs. Of course, that's never going happen. It would reduce wages, and doctors wouldn't like that. It's one of the reasons why our current free trade programs are a sham. If low-wage workers have to compete with foreign labor, the same should be true for high-wage workers.

Quote :

"None of this reveals a major problem with health care access in this country."

According to you. That's a purely subjective judgment. I think it's a problem when millions of people lack access. I don't particularly care if some of these million only experience this state temporarily, could theoretically afford health insurance, or could sign up for Medicaid. I want everyone to have access, period, particularly to preventive care. I think the current system discourages this. I know tend to stay away from doctors, partially because of the confusion and chance I'll have to pay a bunch. And, aaronburro, you're goddamn right I include illegal immigrants. They deserve good health as much as you do.

9/16/2008 11:06:31 AM

Quote :

"I want everyone to have access, period, particularly to preventive care. I think the current system discourages this"

Actually, most plans cover preventative care for free, which is hardly discouraging.

9/16/2008 2:21:16 PM

The current system includes 47 million people without insurance.

9/16/2008 2:32:46 PM

way to use that overinflated figure again. really not helping your argument when you keep going back to refuted claims.

9/16/2008 10:55:11 PM